Find out when GPs refer people to see a skin cancer specialist.
Who should see a specialist
It can be very difficult for GPs to decide who may have a suspected cancer and who may have a minor problem that will go away on its own. With many symptoms, it is right that your GP asks you to wait to see if they get better or respond to treatment such as antibiotics.
There are particular symptoms that mean your GP should refer you to a specialist straight away.
Your GP might make an urgent referral to a specialist if they think you have a squamous cell cancer (SCC), or a rare type of skin cancer. You should be seen within 2 weeks if you have an urgent referral.
Your GP will normally make a non urgent referral if they think you have a basal cell cancer (BCC). But they should consider an urgent referral if they think that the delay could have an impact on how well the treatment works. This might be because of the size of the abnormal area or where it's on your body.
Non urgent referral
You should normally have a non urgent referral to see a specialist if your GP thinks that you have a BCC. There can be a wait of a number of weeks. BCC is the most common type of non melanoma skin cancer. It generally takes years to develop in most people. Waiting a few weeks is unlikely to do any harm.
Talk to your GP if you're worried about the wait, particularly if it has taken a while to see your doctor in the first place.
The exception to this is if your GP thinks a delay could have an impact on how well the treatment works. This might be because of the size of the abnormal area or where it is on your body. In these circumstances, you might have an urgent referral.
GP referral guidelines
The National Institute for Health and Care Excellence (NICE) and the Scottish Government produced guidelines for GPs to help them decide which patients need to be seen urgently by a dermatologist (specialist skin doctor).
Included in this guidance is who should remove BCCs. Some GPs and nurses are specially trained to remove these cancers in community clinics.
The NICE issued guidance in May 2010 recommending that all cancer networks have 2 levels of multidisciplinary teams.
Talk to your doctor if you have been diagnosed with a skin cancer and you're concerned that a multidisciplinary team is not looking after you. It may be that you only see one specialist. But the team have got together with your test results and case notes to discuss the best treatment.
Who you will seeThe multidisciplinary team (MDT) is a team of health professionals who work together to decide on the best way to manage your care. The MDT can include many different health professionals including:
- skin specialists (dermatologists)
- plastic surgeons
- cancer specialists
- doctors who specialise in reading X-rays and scans (radiologists)
- specialist nurses
- GPs with a special interest in skin cancer
- occupational therapists
- cosmetic camouflage advisers
- doctors who make a diagnosis from tissue specimens (histopathologists)
The two levels of MDT are the Local Hospital Skin Cancer MDT and a Specialist Skin Cancer MDT. A Local Hospital Skin Cancer MDT is likely to be in cancer units in district general hospitals. A Specialist Skin Cancer MDT is usually in larger hospitals that have cancer centres or plastic surgery centres.
All of the members of these multidisciplinary teams have specialist training in skin cancer and meet regularly.
Referrals to multidisciplinary teams
Everyone with suspected skin cancer is seen by a member of one of these MDT teams.
Referral to Local Hospital Skin Cancer MDT
For a BCC that isn't likely to come back, you might be seen by your GP if they are a member of the Local Hospital Skin Cancer MDT. Your GP may refer you to the Local Hospital Skin Cancer MDT if:
- you have a BCC that's at a higher risk of coming back or has come back
- you have a SCC or melanoma
- it’s not certain which type of skin cancer you have
- a type of BCC called nodular BCC
- small (less than 1cm)
- being in an area of the body where it is easy to remove
Referral to Local Hospital Skin Cancer MDTYour GP or doctor from the Local Hospital Skin Cancer MDT will refer you to the Specialist Skin Cancer MDT if you:
- have a rare skin cancer
- have SCC or melanoma that's at higher risk of coming back or has come back
- have any type of skin cancer that's spread to another part of your body
- need treatment that the Local Hospital Skin Cancer MDT doesn't provide
- are taking part in a clinical trial